Brain skull traumatism: a neurological approach

Introduction: Brain Cranium Trauma (TBI) is defined as any traumatic injury that causes an anatomical lesion or functional impairment of the scalp, skull, meninges, brain or its vessels. In the set of injuries from external causes, the TBI stands out in terms of magnitude and, above all, as a cause of death and disability. Objectives: Demonstrate basic and current concepts in relation to the pathophysiology, diagnosis and treatment of TBI. Methods: The present work is a narrative review of the literature in the PubMed, SciELO and CNBI databases. As search criteria, the following keywords were used: “traumatic brain injury”; “Semiology”; “Neurology” and articles, which were limited to a specific period of 5 years. Exclusion: case reports and inclusion: 12 articles. Results: The main causes of TBI are car accidents, falls, being run over, aggression and sports activities. It was observed that most victims of TBI have subgaleal hematoma (HS), followed by fractures. In mild and moderate TBI, the appearance of HS is more prevalent, 48.5%. In TBI, severe, the incidence of subarachnoid hemorrhage predominates with 71.1% of cases in the first study and 62.5% in the second. Conclusion: The main group affected by TCE are mostly male and young, this predominance is related to the increase in violence with firearms, alcoholism and high speeds in traffic. The elderly group is at risk due to their susceptibility to falls. Children are also prone due to lack of motor coordination, resulting in acidentes.

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Predictors of positive CT scans in the elderly trauma patients with minor head injury. Case reports and review of the literature

Annals of General Psychiatry ◽

10.1186/1744-859x-7-s1-s302 ◽

2008 ◽

Vol 7 (S1) ◽

Author(s):

Nikolaos Syrmos ◽

Ilias Gramatikopoulos ◽

Vasilios Valadakis ◽

Konstantinos Grigoriou ◽

Dimitrios Arvanitakis

Keyword(s):

Head Injury ◽

Case Reports ◽

The Elderly ◽

Minor Head Injury ◽

Ct Scans ◽

Trauma Patients ◽

Review Of The Literature ◽

Elderly Trauma Patients

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Complete Spontaneous Regression of Merkel Cell Carcinoma

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348940511400507 ◽

2005 ◽

Vol 114 (5) ◽

pp. 376-380 ◽

Cited By ~ 32

Author(s):

Luis Junquera ◽

Aintza Torre ◽

Luis García-Consuegra ◽

Juan C. Vicente ◽

Manuel F. Fresno

Keyword(s):

Computed Tomography ◽

Cell Carcinoma ◽

Merkel Cell Carcinoma ◽

Spontaneous Regression ◽

Case Reports ◽

The Elderly ◽

Merkel Cell ◽

Review Of The Literature ◽

The Right

Merkel cell carcinoma (MCC) is a very aggressive primary cutaneous neoplasm most often occurring on the head and neck of the elderly. Spontaneous regression of MCC was first described in 1986. A 79-year-old woman with MCC on the right cheek underwent spontaneous regression of the malignancy, documented by photographic follow-up, computed tomography, and histologic studies. A review of the literature is presented. Complete clinical and histologic regression of MCC was observed in the present case. Although the literature documents 11 similar cases, only 6 can be regarded as complete spontaneous regressions following exclusive performance of a biopsy (primary complete spontaneous regression). Primary complete spontaneous regression of MCC is infrequent, and most case reports describe this phenomenon in women with MCC on the cheek. The reasons underlying regression are unknown.

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035 Valproate-induced parkinsonism ‘an early warning’: case reports and review of literature

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp-2019-anzan.32 ◽

2019 ◽

Vol 90 (e7) ◽

pp. A12.2-A12

Author(s):

Shoaib Dal ◽

Scott Whyte

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Case Reports ◽

The Elderly ◽

Time Frame ◽

List Type ◽

Review Of The Literature ◽

Hand Tremor ◽

Wheel Rigidity

IntroductionWe describe two cases of valproate-induced parkinsonism, where the parkinsonian features develop after commencing valproate (VPA), in a time frame and manner well described by previous publications.1 In contrast to the published literature, that has short duration of follow-up, we have had a prolonged follow-up of these two cases, who initially improved on ceasing valproate, but then after a period progressed again, with the development of levodopa-responsive asymmetrical Parkinson’s disease.2Cases67 years old man, on VPA 500 mg twice a day for seizures since 2008, developed new rest, re-emergent left hand tremor and hypomimia in 2012. Within months, the parkinsonism progressed to decremental bradykinesia, cog-wheel rigidity and hypophonia. The symptoms initially improved with changing VPA to levetiracetam; however, the disease reappeared after 6 months and although levodopa-responsive, it has been progressive since then.88 years old man, on VPA 700 mg twice a day for seizures since 2010, developed upper limb decremental bradykinesia, cog-wheel rigidity, camptocormia and rest, re-emergent tremor in hands in 2011. The parkinsonism improved significantly with cessation of VPA; however, the disease re-emerged after 2 years and has been progressive since then.ConclusionVPA may be responsible for unmasking underlying subclinical parkinsonism and these patients represent an earlier onset of Parkinson’s disease related to VPA exposure, rather than a purely drug related parkinsonian dysfunction. These cases also highlight the importance of long-term follow up in VPA-induced parkinsonism. These observations are an important consideration for clinicians treating patients with parkinsonian features secondary to VPA exposure.ReferencesBrugger F, Bhatia KP, Besag FM. Valproate-associated parkinsonism: a critical review of the literature. CNS Drugs 2016;30(6):527–540.Mahmoud F, Tampi RR. Valproic acid-induced parkinsonism in the elderly: a comprehensive review of the literature. Am J Geriatr Pharmacother 2011;9(6):405–412.

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Subgaleal Hemorrhage in Infants with Hemophilia: Report of Two Cases and Review of the Literature

PEDIATRICS ◽

10.1542/peds.70.2.306 ◽

1982 ◽

Vol 70 (2) ◽

pp. 306-307

Author(s):

Jo Ann Rohyans ◽

Angela W. Miser ◽

James S. Miser

Keyword(s):

Hemophilia A ◽

Case Reports ◽

Newborn Infants ◽

Review Of The Literature ◽

Newborn Period ◽

Parietal Area ◽

Subgaleal Hematoma ◽

Life Threatening ◽

Prolonged Labor ◽

The Right

Hemorrhage in the newborn period in infants with hemophilia is rarely seen except in those children undergoing circumcision.1 Although reported in only five infants since 1960, scalp hemorrhage in newborn infants with hemophilia may be life-threatening.2-5 We have recently seen two infants with severe hemophilia A; each had a life-threatening subgaleal hematoma in the newborn period. Consumptive coagulopathy complicated the clinical and diagnostic evaluation in one case. CASE REPORTS Case 1 K. J. was a 3,370-gm infant born at 42 weeks' gestation by a forceps delivery after a prolonged labor with oxytocin (Pitocin) augmentation. In the first hours of life, a hematoma was noted over the right parietal area.

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Unusual complication following trauma to a bone-anchored hearing aid: case report and literature review

The Journal of Laryngology & Otology ◽

10.1017/s0022215108002843 ◽

2008 ◽

Vol 123 (3) ◽

pp. 348-350 ◽

Cited By ~ 5

Author(s):

A-L McDermott ◽

J Barraclough ◽

A P Reid

Keyword(s):

Hearing Aids ◽

World Literature ◽

Hearing Aid ◽

Case Reports ◽

Neurological Complication ◽

Traumatic Injury ◽

Unusual Complication ◽

Review Of The Literature ◽

Bone Anchored Hearing Aid ◽

Dubowitz Syndrome

AbstractObjective:We report the second published case of a child with a serious traumatic injury involving the fixture and abutment of their bone-anchored hearing aid.Method:Case reports and review of the world literature concerning unusual complications following trauma to bone-anchored hearing aids.Results:A nine-year-old girl with Dubowitz syndrome sustained an intrusion injury of her bone-anchored hearing aid fixture and abutment following a fall. No other injury was sustained, and there was no neurological complication. The patient underwent immediate removal of the implant and subsequently made a full recovery. Such serious and unusual complications are fortunately very rare. On review of the literature, four cases of similar complications were identified. Only one involved a traumatic injury in a child.Conclusion:Provision of bone-anchored hearing aids involves many clinicians. All clinicians involved in this procedure must be aware of the need to monitor their patients carefully, and to remember that unusual and unexpected complications, although rare, do happen. The patient's need for care continues long after the surgery is complete.

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Refractory Asthma Treatment Is Complicated by Tracheobronchomalacia: Case Reports and Review of the Literature

Case Reports in Medicine ◽

10.1155/2013/735058 ◽

2013 ◽

Vol 2013 ◽

pp. 1-4 ◽

Cited By ~ 5

Author(s):

Sawad Boonpiyathad ◽

Atik Sangasapaviliya

Keyword(s):

Severe Asthma ◽

Case Reports ◽

Persistent Asthma ◽

Posterior Wall ◽

The Elderly ◽

Review Of The Literature ◽

Adequate Treatment ◽

Left Bronchus ◽

The Right ◽

Refractory Asthma

Tracheobronchomalacia (TBM) is defined as the condition where the airway lumen narrows more than 50 percent. The acquired TBM usually occurs in adults; however, the prevalence of TBM in asthma is unknown. We report two cases of severe asthma in elderly patients that could not be controlled with higher medication use. Case 1 was a 70-year-old woman with sever persistent asthma for 10 years, presented with uncontrolled symptoms for 4 months. A CT of the chest showed collapse of the trachea at the posterior wall. Case 2 involved a 72-year-old woman with partly controlled asthma presenting with uncontrolled symptoms for 3 months. A CT of the chest showed normal distal tracheal anteroposterior diameter. However, bronchoscopy showed bronchomalacia at the right and left bronchus of the lower lungs. Patients who have severe asthma, despite adequate treatment with medication, should be further investigated to exclude other diseases that have clinical features similar to asthma such as tracheobronchomalacia, particularly in the elderly.

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Crohn's disease as a differential diagnostic problem in the elderly (case reports)

Zeitschrift für Gastroenterologie ◽

10.1055/s-2006-943385 ◽

2006 ◽

Vol 44 (05) ◽

Author(s):

Z Czeglédi ◽

K Rábai ◽

T Szamosi ◽

B Nádas ◽

J Banai

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Case Reports ◽

The Elderly ◽

Diagnostic Problem

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Treatment of bipolar disorder in the elderly: a review of the literature

Revista Debates em Psiquiatria ◽

10.25118/2236-918x-7-6-3 ◽

2017 ◽

Vol Ano 7 ◽

pp. 26-36

Author(s):

Gilberto Sousa Alves ◽

Felipe Kenji Sudo ◽

Lucas Briand ◽

Johannes Pantel

Keyword(s):

Bipolar Disorder ◽

The Elderly ◽

Review Of The Literature

O transtorno afetivo bipolar (TAB) é uma condição potencialmente grave, caracterizada por mudanças de humor e disfunção cognitiva e funcional. O presente artigo revisa as evidências atualizadas das intervenções farmacológicas e não medicamentosas direcionadas ao TAB em idosos. Diretrizes baseadas em evidências, embora sejam úteis na promoção de uma terapia racional e eficaz, ainda são relativamente reduzidas no TAB em idosos. As recomendações atuais para mania aguda incluem o uso de antipsicóticos atípicos (por exemplo, risperidona, quetiapina, olanzapina), lítio (de maneira criteriosa) e a eleição de valproato como terapia padrão ouro. Na depressão aguda do TAB, os agentes de primeira linha em monoterapia podem incluir lítio, lamotrigina, quetiapina e quetiapina de liberação prolongada. No que se refere à escolha do estabilizador de humor ideal, o maior potencial de efeitos colaterais relacionados ao lítio vem desestimulando sua prescrição em indivíduos idosos. A eletroconvulsoterapia, embora limitada pela evidência, pode ser uma opção para casos graves/refratários.

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